We treated two occupational lung diseases in different situations during military training.The purpose of this study is to investigate the availability of CT scanning for the evaluation of inhalation pulmonary edema. Two soldiers suffered severe lung edema after using a spray for the daily maintenance of their firearms. Four soldiers suffered severe dyspnea after undertaking drills in a narrow zone where numerous smoke bombs had been used. We evaluated these patients from several aspects. CT scans of the chest of spray-induced patients revealed bilateral infiltration predominantly in the upper lung fields. The patients received steroid pulse treatment and gradually recovered. CT scans of the chest of smoke-induced patients revealed bilateral ground-glass attenuation with peripheral lung sparing. The patients gradually recovered with steroid therapy. In accordance with previous studies, CT scans of the chest in our patients demonstrated that the periphery of the lungs remained normal, except in cases of serious injury. When differential diagnosis is required, we consider that CT scans of the chest are particularly useful; CT findings are useful in determining the severity of lung injury as well as the diagnosis of inhalation pulmonary edema.
A case of double primary lung cancer was presented. Transbronchial lung biopsy revealed large cell carcinoma in the right lung and oat-cell (small cell) carcinoma in the left lung of a 75 yearold male. The left lung tumor was accompanied by syndrome of inappropriate secretion of ADH (SIADH). Radiotherapy and chemotherapy reduced the size of left lung tumor, and SIADH disappeared. Autopsy showed adenocarcinoma in the right lung. The incidence of double primary lung cancer, especially adenocarcinoma and small cell carcinoma, was discussed.
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